Dear Ms. Gates,

I applaud you for your tireless work for so many around the world!

I read your interview in Time magazine where you said you will be contributing millions of dollars toward better healthcare for women as they experience perimenopause and its progression to menopause.

Using the name of the disease that perimenopause causes, hypogonadism, and the disease menopause causes, profound hypogonadism, would significantly improve clinical trials which would greatly expand treatment efficacy for peri-menopausal women with hypogonadism and menopausal women with profound hypogonadism.

For instance, if a clinical trial is designed to use Hormone Replacement Therapy (HRT) for menopausal women with profound hypogonadism, then the HRT would include bioidentical hormones and would use estradiol, testosterone, progesterone, and dhea and levels would be maintained in the therapeutic reference range to make sure all of the 100 symptoms of profound hypogonadism are treated.

But this has never happened in the history of clinical trials.

If a clinical trial is designed to use HRT for menopausal women, then the HRT wouldn’t be HRT at all. This hormone regimen would only include estradiol, no testosterone, no dhea, and only progesterone for women with a uterus. There would be no hormone testing, which means there would be no interest in hormone levels. The goal would be to treat as few symptoms as possible, perhaps 1 or 2 symptoms (hot flashes, reduce bone loss) of the 100 symptoms of profound hypogonadism.

Treating a disease means treating all of the symptoms for maximum health benefits and a robust quality of life.

Treating menopause means treating just a few of the most bothersome symptoms to make life tolerable.

In the history of clinical trials, there has never been an attempt to maintain estradiol, testosterone, progesterone, and dhea in the therapeutic range for each hormone because the therapeutic range has never been defined for a menopausal woman with profound hypogonadism.

Think about it.

Clinical trials that treat menopausal women treat as few symptoms as possible but clinical trials that treat menopausal women with profound hypogonadism would treat as many symptoms as possible.

Here is an example of the difference.

What is the therapeutic range for estradiol, testosterone, progesterone, and dhea for a menopausal woman? The answer is that no one knows and no one is running clinical trials to find out.

What is the therapeutic range for estradiol, testosterone, progesterone, and dhea for a menopausal woman with profound hypogonadism? The answer is also that no one knows but it would be mandatory to have clinical trials to find out.

Whether a woman has symptoms or not, if she is menopausal, she has profound hypogonadism. Like high blood pressure that has no symptoms, profound hypogonadism, symptoms or not, will take an enormous toll on a woman’s overall health.

Hypogonadism doesn’t have to advance to profound hypogonadism if the scientific rigor that can make hormone replacement therapy successful is applied to the treatment of hypogonadism and profound hypogonadism.

Please support clinical trials that look for the therapeutic levels of all of the ovarian hormones simultaneously for the treatment of hypogonadism and profound hypogonadism.

Melinda French Gates Is Donating $215 Million to Women’s Health

Thank you,
Beth Rosenshein
Co-founder Diamond Research Foundation